Provider Demographics
NPI:1679645618
Name:POWERS, MERIN MICHI (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:MERIN
Middle Name:MICHI
Last Name:POWERS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2391 HARRIS CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-1127
Mailing Address - Country:US
Mailing Address - Phone:408-448-1844
Mailing Address - Fax:
Practice Address - Street 1:270 INTERNATIONAL CIR
Practice Address - Street 2:TWO NORTH
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1130
Practice Address - Country:US
Practice Address - Phone:408-972-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19013225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist